1. Oct 20, 2020

Antibiotic use may shorten survival in patients with urothelial carcinoma treated with immunotherapy

Antibiotic use in patients with urothelial carcinoma treated with atezolizumab was associated with worse survival, according to a post hoc analysis of the IMvigor210 and IMvigor211 clinical trials.

In this study, researchers defined antibiotic use as any antibiotic administered between 30 days prior to and 30 days after the initiation of treatment. In the 847 patients treated with atezolizumab, antibiotic use was associated with worse overall survival (HR [95% confidence interval {CI}] = 1.44 [1.19–1.73]) and progression free survival (1.24 [1.05–1.46]). In the 415 patients treated with chemotherapy, antibiotic use was not associated with worse overall survival and progression free survival.

In a randomized cohort of participants from the IMvigor211 trial, the overall survival treatment effect of atezolizumab versus chemotherapy for antibiotic users and for nonusers were 0.95 and 0.73, respectively.

The authors concluded that these results do not justify a change in antibiotic use for infections but antibiotic overuse in patients with cancer need to be evaluated with immune checkpoint inhibitors.

Hopkins AM, Kichendadasse G, Karapetis CS, et al.Concomitant antibiotic use and survival in urothelial carcinoma treated with atezolizumab. Eur Urol. 2020; DOI:https://doi.org/10.1016/j.eururo.2020.06.061